22400 RESTORATIONS PREFABRICATED, PLASTIC, PRIMARY TEETH
20000 | RESTORATION |
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22000 | RESTORATIONS, PREFABRICATED, FULL COVERAGE |
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22400 | RESTORATIONS PREFABRICATED, PLASTIC, PRIMARY TEETH | ||
22401 | Primary Anterior |
182.5 | 182.5 |
22411 | Primary Posterior |
182.5 | 182.5 |